Nursing diagnosis – IMPAIRED DENTITION

IMPAIRED  DENTITION

DEFINITION

Disruption in tooth development and eruption patterns or structural

integrity of individual teeth

DEFINING CHARACTERISTICS

• Caries; extractions; evidence of periodontal disease

• Evulsion

• Inability or unwillingness of parents or caregiver to provide child

with dental care; lack of access to dental care

• Lack of knowledge of appropriate dental hygiene practices

• Malocclusion; plaque; toothache

• Loose teeth; premature loss of primary teeth

• Erosion of enamel

RELATED FACTORS

• Barriers to self-care

• Ineffective oral hygiene

• Bruxism

• Nutritional deficits

• Chronic use of coffee, tea, red

• Sensitivity to cold

wine, tobacco

• Sensitivity to heat

• Chronic vomiting

ASSESSMENT FOCUS    (Refer  to  comprehensive  assessment  parameters.)

• Knowledge

• Roles/responsibilities

• Nutrition

• Values and beliefs

EXPECTED OUTCOMES

The individual will

• Brush teeth with minimal supervision.

• Demonstrate good brushing technique.

• Not show evidence of dental caries, periodontal disease, or maloc-

clusion.

• Reduce quantity of cariogenic foods in his or her diet.

• Show evidence of good daily oral hygiene.

SUGGESTED NOC OUTCOME

Oral Hygiene; Self-Care: Oral Hygiene

INTERVENTIONS AND RATIONALES

Determine: Assess dental history; primary and secondary tooth devel-

opment; frequency of visits to dentist; frequency of brushing; condi-

tion of the teeth; nutritional status; medications; socioeconomic sta-

tus. Assessment of these factors will help to identify appropriate

interventions.

Perform: Provide tooth brush, toothpaste, and dental floss.

Schedule times for brushing and have patient begin keeping a

record. Keeping a record will promote compliance.

Inform: Teach child principles of good oral hygiene by using teaching

methods appropriate to his age-group to foster compliance.

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Teach the child and his or her parents or caregiver about the rela-

tionship between diet and dental health. Show the child pictures that

promote good dental health and pictures of foods that lead to den-

tal decay. If the child can read, teach him or her to read labels;

teach him or her to avoid products with excessive sucrose. Sucrose

is a simple sugar that promotes dental decay.

Demonstrate good brushing technique. Stress the importance of

having teeth feel clean rather than the need to follow a specific pro-

cedure.

Attend: Encourage parents to create a pleasant mealtime environment

with nutritious foods made to look appealing to a child so that the

child will learn to recognize nutritious foods.

Give positive reinforcement for good choices. Be supportive to the

parents as they try to help the child modify diet to include more

nutritional foods. It is not easy to teach children to make right food

choices, and parents benefit from encouragement to keep reinforcing

good healthy choices.

Encourage ample fluid intake to keep gums well hydrated.

Adequate fluids promote healthy gums.

Manage: Refer to dentist for assessment of dental health.

Schedule a follow-up appointment with parents to ensure they

have taken child to the dentist.

Where it is indicated, refer to a nutritionist for help in modifying

diet.

SUGGESTED NIC INTERVENTIONS

Oral Health Maintenance; Oral Health Promotion; Teaching:

Individual

Reference

Melvin, C. S. (2006, January–February). A collaborative community based

oral care program for school age children. Clinical Nurse Specialist, 20(1),
18–22.

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